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NY Claims Adjuster practice questions

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Question 1Insurance Principles and Concepts

The principle of indemnity is intended to place an insured in which position after a loss?

  1. A better financial position than before the loss
  2. The same financial position as before the loss Correct answer.
  3. A position equal to the policy's face amount regardless of loss
  4. A position determined by the insurer's profits

Explanation

Indemnity is the principle that a property or liability loss should not leave the insured better off than before the loss. The insurer pays the actual amount of the covered loss, subject to policy limits, rather than a windfall.

Question 2Insurance Principles and Concepts

Which party must have an insurable interest at the time of loss for a property insurance claim to be valid?

  1. The adjuster
  2. The mortgagee only
  3. The named insured Correct answer.
  4. The insurance broker

Explanation

In property insurance, the named insured must have an insurable interest at the time of loss for the claim to be enforceable. Insurable interest is a financial stake in the property that would be harmed by a loss.

Question 3Insurance Principles and Concepts

An insurance policy is considered an aleatory contract because:

  1. The insurer's payment may greatly exceed the premium Correct answer.
  2. Both parties exchange equal value at the same time
  3. The insurer promises to pay only after a loss
  4. The insured may cancel at any time

Explanation

An aleatory contract is one in which the parties exchange unequal values depending on chance. The insured pays a relatively small premium, but the insurer may pay a much larger amount if a covered loss occurs.

Question 4Insurance Principles and Concepts

Which type of risk involves only the possibility of loss or no loss, with no possibility of gain?

  1. Business risk
  2. Speculative risk
  3. Pure risk Correct answer.
  4. Investment risk

Explanation

Pure risk involves only the chance of loss or no loss, with no possibility of gain, which is why it is insurable. Speculative risk includes the possibility of gain or loss and generally is not insured.

Question 5Insurance Principles and Concepts

The law of large numbers helps insurers predict losses by:

  1. Setting premiums from a single claim
  2. Reducing the number of policies sold
  3. Increasing similar exposure units Correct answer.
  4. Guaranteeing that no losses will occur

Explanation

Under the law of large numbers, as the number of similar exposure units increases, actual loss experience tends to approach expected loss experience. This makes premiums and reserves more predictable.

Question 6Insurance Principles and Concepts

A slippery floor in a grocery store is best described as which of the following?

  1. A risk
  2. A loss
  3. A hazard Correct answer.
  4. A peril

Explanation

A hazard is a condition that increases the chance or severity of a loss, such as a slippery floor. A peril is the actual cause of loss, such as a fall.

Question 7Insurance Principles and Concepts

An insured intentionally fails to disclose a material fact that would affect the insurer's decision to issue the policy. This most directly violates which principle?

  1. The contribution principle
  2. The indemnity principle
  3. Utmost good faith Correct answer.
  4. The subrogation principle

Explanation

Utmost good faith requires applicants and insurers to deal honestly and disclose material facts. Concealing a material fact can allow the insurer to rescind or deny coverage.

Question 8Insurance Principles and Concepts

After paying a covered collision loss, an insurer discovers the other driver was at fault. The insurer's right to pursue the other driver is known as:

  1. Contribution
  2. Abandonment
  3. Coinsurance
  4. Subrogation Correct answer.

Explanation

Subrogation gives the insurer the right to stand in the insured's shoes and recover from the party responsible for the loss after paying the claim. This prevents the insured from collecting twice and helps hold the responsible party accountable.

Question 9Insurance Principles and Concepts

A policy pays actual cash value (ACV). A five-year-old machine with a replacement cost of $10,000 and expected life of ten years is destroyed. Using straight-line depreciation, what is the ACV?

  1. $5,000 Correct answer.
  2. $2,000
  3. $10,000
  4. $7,500

Explanation

ACV equals replacement cost minus depreciation. With a ten-year life and five years used, depreciation is 50%, or $5,000, so ACV is $10,000 minus $5,000.

Question 10Insurance Principles and Concepts

A property policy has an 80% coinsurance clause and a $200,000 building. The insured carries $120,000. A $50,000 loss occurs. What amount does the insurer pay, assuming no deductible?

  1. $30,000
  2. $40,000
  3. $37,500 Correct answer.
  4. $50,000

Explanation

The coinsurance requirement is 80% of $200,000, or $160,000. Because the insured carried $120,000, the insurer pays (120,000 ÷ 160,000) × $50,000 = $37,500, subject to the policy limit.

Question 11Insurance Principles and Concepts

A policy has a $1,000 deductible and a $10,000 limit. A covered loss is $7,500. How much does the insurer pay?

  1. $1,000
  2. $8,500
  3. $6,500 Correct answer.
  4. $7,500

Explanation

A deductible is subtracted from the covered loss before the insurer pays. $7,500 minus the $1,000 deductible equals $6,500, which is within the $10,000 limit.

Question 12Insurance Principles and Concepts

A windstorm knocks down a power line, causing a fire that damages a building. The windstorm is best described as the:

  1. Remote cause
  2. Concurrent cause
  3. Intervening cause
  4. Proximate cause Correct answer.

Explanation

Proximate cause is the dominant, efficient cause that sets a chain of events in motion without a break. The windstorm proximately caused the fire damage because the fire was a natural consequence of the windstorm.

Question 13Insurance Principles and Concepts

An insurer's adjuster tells the insured that proof of loss may be filed late. The insurer later denies the claim for late filing. Which doctrine may prevent the denial?

  1. Coinsurance
  2. Abandonment
  3. Subrogation
  4. Estoppel Correct answer.

Explanation

Estoppel prevents a party from asserting a right after its conduct induced another party to rely to their detriment. If the adjuster led the insured to believe late filing was acceptable, the insurer may be estopped from denying the claim on that basis.

Question 14Insurance Principles and Concepts

A statement made by an applicant on an insurance application that is believed to be true to the best of the applicant's knowledge is a:

  1. An express warranty
  2. A policy condition
  3. Representation Correct answer.
  4. Concealment

Explanation

A representation is a statement of fact made by the applicant that is believed to be true to the best of their knowledge. A warranty, by contrast, is a promise or condition that must be literally true.

Question 15Insurance Principles and Concepts

An insurance binder provides which of the following?

  1. Temporary evidence of coverage Correct answer.
  2. A guarantee that the insurer will not cancel
  3. A permanent policy with all endorsements attached
  4. A legal opinion on coverage

Explanation

A binder is temporary evidence of coverage that bridges the gap until the policy is issued. It is subject to the terms of the policy to be issued.

Question 16Insurance Principles and Concepts

An insured who intentionally damages their own property to collect insurance proceeds presents which type of hazard?

  1. Physical hazard
  2. Legal hazard
  3. Moral hazard Correct answer.
  4. Morale hazard

Explanation

Moral hazard arises from dishonesty or intentional conduct, such as deliberately damaging property to collect insurance. Morale hazard, by contrast, arises from carelessness or indifference.

Question 17Insurance Principles and Concepts

Under the efficient proximate cause rule, when a covered peril and an excluded peril combine to cause a loss, coverage depends on:

  1. Whether the insured had notice of the excluded peril
  2. Whether the excluded peril occurred first in time
  3. Which peril was the dominant efficient cause Correct answer.
  4. The percentage of damage caused by each peril

Explanation

Under the efficient proximate cause rule, the dominant cause that sets the loss in motion determines coverage. If a covered peril is the efficient proximate cause, the loss may be covered even if an excluded peril contributed.

Question 18Insurance Principles and Concepts

An insurer that cedes a single large risk to a reinsurer on a case-by-case basis is using:

  1. Facultative Correct answer.
  2. Retrocession arrangement
  3. Coinsurance provision
  4. Treaty reinsurance agreement

Explanation

Facultative reinsurance is arranged case by case, giving the ceding insurer the option to submit individual risks and the reinsurer the option to accept them. Treaty reinsurance, by contrast, automatically covers a defined class of business.

Question 19Insurance Principles and Concepts

Two policies cover the same loss on the same property. Insurer A has a $100,000 limit and Insurer B has a $300,000 limit. Under the pro rata contribution method, how is the loss shared?

  1. Equally, regardless of limits
  2. In proportion to each insurer's limit Correct answer.
  3. Insurer A pays first until its limit is exhausted
  4. Based on which policy was issued first

Explanation

Under pro rata contribution by limits, each insurer pays a share of the loss based on its limit compared with the total limits. Equal shares, primary/excess ordering, and policy issuance dates do not determine pro rata contribution.

Question 20Insurance Principles and Concepts

A policy contains a 90% coinsurance clause and a $500,000 limit. The building's replacement cost is $1,000,000, but the insured carries only $600,000. A $300,000 loss occurs. What does the insurer pay?

  1. $270,000
  2. $240,000
  3. $300,000
  4. $200,000 Correct answer.

Explanation

The coinsurance requirement is 90% of $1,000,000, or $900,000. The insured carried $600,000, so the insurer pays (600,000 ÷ 900,000) × $300,000 = $200,000, within the $500,000 limit.

Question 21New York Insurance Law and Regulations

Under the New York Insurance Law, which of the following individuals is required to hold an independent adjuster license?

  1. A licensed attorney who negotiates a settlement for a client
  2. A salaried employee who adjusts claims for his or her own employer insurer
  3. A person who for a fee investigates and settles claims for an insurer Correct answer.
  4. An officer of a corporation who settles a claim on its own property policy

Explanation

Insurance Law §2102 bars any person from acting as an insurance adjuster without a license, and §2101(g)(1) defines an independent adjuster as one who, for compensation, acts on behalf of an insurer in adjusting claims. Officers and regular salaried employees of an insurer adjusting that insurer's own claims fall outside the licensing requirement, and attorneys acting for clients are not acting as adjusters for an insurer.

Question 22New York Insurance Law and Regulations

A public adjuster licensed in New York negotiates and settles claims on behalf of which party?

  1. The Superintendent of Financial Services
  2. The insurer that issued the policy
  3. The mortgagee named in the policy
  4. The insured, for compensation Correct answer.

Explanation

Insurance Law §2101(g)(2) defines a public adjuster as a person who, for compensation, acts on behalf of an insured in negotiating, adjusting, or settling a first-party claim. A person may not act as both a public adjuster and an independent adjuster on the same claim.

Question 23New York Insurance Law and Regulations

How many hours of approved continuing education must a New York licensed independent adjuster complete every two years?

  1. Ten credit hours
  2. Fifteen credit hours Correct answer.
  3. Twenty-four credit hours
  4. Twelve credit hours

Explanation

New York requires licensed insurance professionals, including independent adjusters, to complete 15 credit hours of approved continuing education during each two-year license period, with a portion devoted to ethics. Satisfactory completion is a condition of continuing to hold the license.

Question 24New York Insurance Law and Regulations

Under Regulation 64, an insurer must acknowledge receipt of notification of a claim within what period?

  1. Twelve business days
  2. Five business days
  3. Fifteen business days Correct answer.
  4. Ten business days

Explanation

11 NYCRR 216.4 requires an insurer to acknowledge receipt of notification of a claim within 15 business days. The acknowledgement obligation runs to the claimant and applies regardless of whether liability or coverage has been determined.

Question 25New York Insurance Law and Regulations

After receiving a properly executed proof of loss, an insurer subject to Regulation 64 must pay or deny the claim within:

  1. Thirty calendar days Correct answer.
  2. Ninety calendar days
  3. Sixty calendar days
  4. Fifteen business days

Explanation

11 NYCRR 216.5 requires the insurer to pay or deny a claim within 30 calendar days after receipt of a properly executed proof of loss. If the investigation cannot be completed in that time, the insurer must explain the delay in writing and continue to update the claimant.

Question 26New York Insurance Law and Regulations

A single isolated mistake in handling one claim ordinarily will not constitute a violation of Insurance Law §2601 because that statute requires:

  1. That the claim arise under a life insurance policy
  2. Automatic strict liability for each processing error
  3. Conduct committed without just cause as a general business practice Correct answer.
  4. That the claim involve a third-party claimant

Explanation

Insurance Law §2601 prohibits unfair claim settlement practices only when the acts are committed without just cause and with such frequency as to indicate a general business practice. Enforcement therefore focuses on patterns of conduct rather than on one isolated error.

Question 27New York Insurance Law and Regulations

A no-fault insurer receives a complete proof of claim but does not pay within 30 days. Under New York's no-fault law, the benefits become overdue and the insurer owes:

  1. Nothing additional unless the claimant files suit
  2. Interest at two percent per month plus reasonable attorney's fees Correct answer.
  3. A flat ten percent penalty on the unpaid amount
  4. Interest at one percent per month with no fees

Explanation

Insurance Law §5106(a) provides that first-party benefits are overdue if not paid within 30 days after the claimant supplies proof of the amount due. Overdue benefits accrue interest at two percent per month, and the claimant may also recover reasonable attorney's fees.

Question 28New York Insurance Law and Regulations

What is the maximum basic economic loss recoverable as no-fault benefits for one person injured in a New York motor vehicle accident?

  1. $10,000 per person
  2. $50,000 per person Correct answer.
  3. $25,000 per person
  4. $100,000 per person

Explanation

Insurance Law §5102 sets basic economic loss at up to $50,000 per person, consisting of necessary medical expenses, lost earnings up to a monthly cap, and other reasonable and necessary expenses up to a daily cap. Benefits beyond that amount are not payable as basic economic loss.

Question 29New York Insurance Law and Regulations

An injured driver wants to sue the at-fault driver for pain and suffering after a New York auto accident. To recover non-economic damages, the driver must establish that:

  1. The other driver was issued a traffic citation
  2. No-fault benefits have been fully exhausted
  3. The injury meets the statutory serious injury threshold Correct answer.
  4. Basic economic loss exceeded $50,000

Explanation

Insurance Law §5104(a) abolishes tort liability for non-economic loss arising from a covered motor vehicle accident except for serious injury as defined in §5102(d). The threshold is a legal test applied to the medical evidence, not a function of the ticket issued or the benefits paid.

Question 30New York Insurance Law and Regulations

Which statement correctly describes supplementary uninsured/underinsured motorist (SUM) coverage in New York?

  1. It applies only when the at-fault driver carries no insurance at all
  2. It is required only for commercial auto fleets
  3. It must be offered and pays when the at-fault driver is underinsured Correct answer.
  4. It merely duplicates mandatory UM limits and cannot be increased

Explanation

Insurance Law §3420(f) requires insurers to offer SUM coverage so that an insured can recover for a serious injury caused by a motorist whose liability limits are lower than the insured's SUM limit. The insured must carry the coverage and follow the policy's notice and consent conditions.

Question 31New York Insurance Law and Regulations

A New York personal auto insurer cancels a policy because the insured failed to pay the premium. What is the minimum advance written notice the insurer must give?

  1. At least five days
  2. At least seven days
  3. At least ten days Correct answer.
  4. At least forty-five days

Explanation

Insurance Law §3425 requires the insurer to mail the insured written notice of cancellation for nonpayment of premium at least ten days before the effective date. Longer notice periods apply to cancellations for other permissible reasons after the policy has been in effect for 60 days.

Question 32New York Insurance Law and Regulations

The New York standard fire policy prescribed by Insurance Law §3403 insures against:

  1. Fire, windstorm and hail
  2. Fire, lightning and removal from endangered premises Correct answer.
  3. Fire and smoke only
  4. All risks of direct physical loss

Explanation

The New York standard fire policy insures against all direct loss and damage by fire and lightning, and extends to property removed from premises endangered by the insured perils. Extended coverage perils such as windstorm must be added by endorsement.

Question 33New York Insurance Law and Regulations

An insurer decides a bodily injury claim falls outside coverage. Under Insurance Law §3420(d), the insurer must:

  1. Issue the disclaimer within 90 days of the accident
  2. Wait until the claimant obtains a judgment
  3. Give written notice of disclaimer as soon as reasonably possible Correct answer.
  4. Obtain the Superintendent's approval before disclaiming

Explanation

Section 3420(d)(2) requires an insurer disclaiming coverage for death or bodily injury to give written notice of the disclaimer to the insured and the injured claimant as soon as is reasonably possible. An unjustified delay can bar the insurer from relying on the exclusion.

Question 34New York Insurance Law and Regulations

For a liability policy issued after January 17, 2009, an insurer seeking to deny a claim solely because the insured provided late notice must establish that it:

  1. Faced a claim exceeding the policy limit
  2. Believed the insured acted in bad faith
  3. Received the notice more than 30 days late
  4. Was prejudiced by the delay Correct answer.

Explanation

Insurance Law §3420(a)(5) provides that an insured's failure to give timely notice does not invalidate a claim unless the insurer has been prejudiced by the failure. The burden of showing prejudice rests with the insurer.

Question 35New York Insurance Law and Regulations

Under New York's insurance privacy regulation, an insurer that wishes to disclose nonpublic personal financial information to a nonaffiliated third party generally must first:

  1. Obtain the Superintendent's written approval
  2. Complete the disclosure and notify the customer afterward
  3. Restrict the disclosure to credit report data
  4. Provide notice and a reasonable opportunity to opt out Correct answer.

Explanation

11 NYCRR Part 169 implements federal privacy law in New York by requiring initial and annual privacy notices and, before sharing nonpublic personal financial information with nonaffiliated third parties, a clear notice and a reasonable opportunity for the customer to opt out. Certain statutory exceptions apply.

Question 36New York Insurance Law and Regulations

An insurer learns that an applicant misstated the loss history on a commercial property application. The insurer may avoid the policy only if the misstatement was:

  1. Made anywhere in the application documents
  2. Followed by the insured's signature
  3. Discovered within one year of issuance
  4. Material and induced the insurer to issue the policy Correct answer.

Explanation

Insurance Law §3105 provides that misrepresentations do not avoid a policy unless they are material, and for most policies the misrepresentation must also have been made with intent to deceive. A statement is material when the insurer would not have issued the policy on the same terms had it known the truth.

Question 37New York Insurance Law and Regulations

Following a fire loss, the New York standard fire policy requires the insured to:

  1. Complete all permanent repairs before filing a proof of loss
  2. Deliver the damaged property to the insurer as salvage
  3. Retain a public adjuster before notifying the insurer
  4. Protect the property from further damage and record related expenses Correct answer.

Explanation

The standard fire policy's duties after loss include protecting the property from further damage, separating damaged from undamaged property, and keeping an accurate record of expenditures made to protect the property. Those expenses are recoverable as part of the loss.

Question 38New York Insurance Law and Regulations

Claims of policyholders of an insolvent insurer licensed to write property/casualty insurance in New York are protected primarily by:

  1. A guaranty pool operated by the National Association of Insurance Commissioners
  2. The New York Property/Casualty Insurance Security Fund Correct answer.
  3. The federal Terrorism Risk Insurance Program
  4. The Department of Financial Services' consumer complaint account

Explanation

Article 76 of the Insurance Law establishes the New York Property/Casualty Insurance Security Fund, which pays covered claims against insolvent insurers licensed in New York, subject to statutory limits. Separate funds exist for other lines, such as Workers' Compensation.

Question 39New York Insurance Law and Regulations

Under New York's no-fault regulation, an injured person must give the insurer written notice of the accident within ___ and submit proof of claim within ___.

  1. 60 days; 180 days
  2. 10 days; 30 days
  3. 30 days; 45 days Correct answer.
  4. 20 days; 90 days

Explanation

11 NYCRR 65-2.4 requires written notice of the accident within 30 days, or as soon as reasonably practicable, and submission of the proof of claim form within 45 days after the accident. Late submission may be excused where the delay was reasonable.

Question 40New York Insurance Law and Regulations

A claimant obtains a judgment against an insured that the insurer refuses to pay. Under Insurance Law §3420, the claimant may:

  1. Sue the insurer directly to recover the judgment, up to policy limits Correct answer.
  2. Foreclose on the insurer's assets in Supreme Court
  3. Require the Superintendent to levy a fine equal to the judgment
  4. Collect from the Security Fund without any claim proceeding

Explanation

Section 3420(b)(1) permits a judgment creditor whose judgment remains unsatisfied to maintain an action directly against the insurer, subject to the policy's terms and limits. The statute also addresses situations where the insured becomes insolvent.

Question 41New York Insurance Law and Regulations

The insurer and the insured agree that a fire loss is covered but disagree about its dollar value. Under the standard fire policy, either party may:

  1. Ask the Superintendent to fix the amount of the loss
  2. Demand an appraisal with one appraiser chosen by each side Correct answer.
  3. Require the insured to accept the insurer's written estimate
  4. Submit the valuation dispute to a jury before repairs begin

Explanation

The standard fire policy's appraisal provision allows either party to demand an appraisal when the amount of loss is disputed; each side selects a competent appraiser, and an umpire resolves differences. Appraisal addresses valuation only, not questions of coverage.

Question 42New York Insurance Law and Regulations

A notice of cancellation of a New York personal auto policy must include:

  1. The specific reason or reasons for cancellation Correct answer.
  2. The names of the underwriters who approved it
  3. The insured's current credit score
  4. The exact dollar amount of unearned premium to be refunded

Explanation

Insurance Law §3425 requires that a notice of cancellation set forth the specific reason or reasons for the cancellation and be mailed to the insured at the address shown in the policy, with proof of mailing retained. A policy may not be cancelled for reasons that the statute does not permit.

Question 43New York Insurance Law and Regulations

An insurer cannot finish investigating a claim within the periods set by Regulation 64. The insurer should:

  1. Pay the undisputed portion and waive the balance
  2. Send the file to the Superintendent for adjudication
  3. Close the claim and reopen it when the investigation ends
  4. Notify the claimant in writing of the reasons for the delay Correct answer.

Explanation

Regulation 64 does not allow a claim to sit unresolved; where more time is needed, the insurer must give the claimant written notice explaining the reasons the claim has not been settled. The insurer must continue to investigate diligently and respond promptly to inquiries.

Question 44New York Insurance Law and Regulations

Which of the following is a ground on which the Superintendent may suspend or revoke an adjuster's license?

  1. Settling a claim before the policy's reporting deadline
  2. Disclosing the fee arrangement to the client in writing
  3. Demonstrated untrustworthiness or incompetence in handling claims Correct answer.
  4. Adjusting claims for more than one insurer in a year

Explanation

Insurance Law §2110 authorizes the Superintendent to revoke or suspend a license, or impose a fine, where the licensee has demonstrated untrustworthiness or incompetence, engaged in fraudulent or dishonest practices, or violated the Insurance Law. Prompt and honest claim handling is the standard expected of licensees.

Question 45New York Insurance Law and Regulations

A claimant complains that the amount offered on her claim is too low. Which statement best describes the Superintendent's role?

  1. The Superintendent must approve every settlement above $25,000
  2. The Superintendent refers every valuation dispute to the Insurance Frauds Bureau
  3. The Department may look into unfair claim practices but does not fix the amount owed Correct answer.
  4. The Superintendent arbitrates the dispute and issues a binding award

Explanation

Insurance Law §2601 addresses patterns of unfair claim settlement practice, so the Department may investigate an insurer's conduct and take disciplinary action. It does not act as a tribunal that determines the value of an individual claim, which the parties resolve by agreement or litigation.

Question 46New York Insurance Law and Regulations

Under New York Insurance Law, which of the following persons must hold an independent adjuster license?

  1. An attorney who adjusts a loss for a client in connection with pending litigation
  2. A salaried employee of an insurer who investigates claims for that same insurer
  3. An independent contractor retained by an insurer to investigate and settle claims Correct answer.
  4. A public adjuster who negotiates a settlement on behalf of an insured

Explanation

Insurance Law §2101(g)(1) defines an independent adjuster as a person who, for compensation, investigates and settles claims on behalf of an insurer, and §2108 requires that person to be licensed. Salaried employees of the insurer, attorneys adjusting for their own clients, and public adjusters acting for insureds fall outside that license category.

Question 47New York Insurance Law and Regulations

Which authority issues and renews adjuster licenses in New York?

  1. The Attorney General
  2. The Workers' Compensation Board
  3. The Superintendent of Financial Services Correct answer.
  4. The Secretary of State

Explanation

The Insurance Law is administered by the Superintendent of Financial Services, who heads the Department of Financial Services, and adjuster licenses are issued and renewed by that office. Other state offices do not license adjusters.

Question 48New York Insurance Law and Regulations

Which of the following is expressly identified in Insurance Law §2601 as an unfair claim settlement practice?

  1. Requiring a claimant to submit a sworn proof of loss form
  2. Declining to pay a claim on which coverage is genuinely in dispute
  3. Failing to adopt and implement reasonable standards for the prompt investigation of claims Correct answer.
  4. Requesting a recorded statement from a claimant during the investigation

Explanation

Section 2601(a)(3) lists failing to adopt and implement reasonable standards for the prompt investigation of claims as a defined unfair claim settlement practice. Requesting proofs of loss or recorded statements, and contesting claims that are fairly debatable, are not themselves violations.

Question 49New York Insurance Law and Regulations

A New York insurer receives notification of a first-party property claim. Under Regulation 64, the insurer must acknowledge receipt of the notification within how many business days?

  1. Twenty business days
  2. Ten business days
  3. Fifteen business days Correct answer.
  4. Five business days

Explanation

11 NYCRR 216.4(a) requires an insurer to acknowledge receipt of notification of a claim within 15 business days. The regulation then sets additional deadlines for furnishing claim forms and completing the investigation.

Question 50New York Insurance Law and Regulations

A commercial lines insurer intends to renew a policy but condition the renewal on reducing the coverage. Under Insurance Law §3426(e), the insurer must give the insured written notice at least how many days before the policy expires?

  1. Sixty days Correct answer.
  2. Ten days
  3. Ninety days
  4. Thirty days

Explanation

Section 3426(e) requires at least 60 days' advance written notice when an insurer conditions renewal on reduced limits or coverage, an increased deductible, or an added exclusion. The insured may then reject the conditioned renewal and seek other coverage.